Compassion, Suffering, and Moral Convictions: The Response to Gender Reassignment Surgery

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On April 24, 2015, Bruce Jenner, decathlon champion at the 1976 Olympics, announced his transgender identity to Diane Sawyer on the television program 20/20. Describing his own self-identity, Jenner claimed God gave him “the soul of a female.”[1] On June 1, 2015, Jenner announced via Twitter the new identity of Caitlyn Jenner and said, “I’m so happy after such a long struggle to be living my true self. Welcome to the world Caitlyn. Can’t wait for you to get to know her/me.”[2] On July 15, 2015, Jenner received the Arthur Ashe Award at the ESPY Awards in Los Angeles. Wearing a white Versace gown, Jenner said, “I trained hard, I competed hard, and for that people respected me. But this transition has been harder on me than anything I could imagine, and that’s the case for so many others, besides me. For that reason alone, trans people deserve something vital, they deserve your respect.”[3] Similar to Jenner, many people argue that in the name of compassion Christians should affirm gender transitioning.

Our transgender neighbors believe transitioning is a morally permissible way to alleviate the suffering associated with their personal struggles. Professional organizations recommend transitioning as the standard treatment for gender dysphoria.[4] In other words, the body is made to conform to the person’s internal sense of gender identity instead of working to accept the body one has. Transitioning includes puberty blockers, hormone therapy, and various surgical interventions, which can be divided into three categories: cosmetic surgery (facial appearance and body contouring), top surgery (breast implants for male to female transgender or double mastectomies for female to male transgender), and bottom surgery (castration and neo-vaginas for male to female transgender and neo-phalluses for female to male transgender). The claim is that such procedures will reduce the person’s suffering and lead to a better quality of life.

Does compassion demand that Christians affirm gender transitioning to relieve suffering? While Scripture commands Christians to be compassionate, I will argue the entire worldview of modern transgenderism is in direct conflict with Christian ethics. The example of gender transitioning provides an opportunity for us to explore how to join compassion, kindness to those who are suffering, and clear Biblical convictions.

Christian compassion is the sympathetic consciousness of the needs or distresses of another person along with a desire to help remove or alleviate the problems, and is a virtue to be exercised within Scriptural moral boundaries.[5] Jesus Christ demonstrated compassion in times of death (Luke 7:13; John 11:1–46), he extended compassion to people distraught by the effects of sin (Luke 7:36–50), and he vividly taught about God’s compassion in the parable of the prodigal son, in which the father saw his son while he was a long way off “and felt compassion for him, and ran and embraced him and kissed him” (Luke 15:20, NASB). Colossians 3:12 instructs Christians to put on “compassionate hearts, kindness, humility, meekness, and patience” (ESV). Compassion is part of the moral garment for a Christian, and it is to be expressed in concrete ways.[6]

First, we can affirm the reality of the suffering associated with gender dissonance without affirming the spectrum of transgender ideology. In compassion we can acknowledge our friends’ internal pain and grant that they are not lying to us about deeply conflicting emotions regarding their own identities. Peter Toon reminded that compassion is an “expression of genuine love which both feels the agony of another and enters into that agony in order to help.”[7] All of us experience the pains and griefs of living in a broken world. Romans 12:15 tells us, “Rejoice with those who rejoice, weep with those who weep.” We can weep with a friend undergoing the most trying grief related to dissonance regarding his or her own body. Convictional opposition to gender reassignment is not inconsistent with affirming a friend’s deep agony.

Second, we shape our view of compassion by the narrative of the Bible. In contrast, our culture uses fragments of the lost echo of Christian ethics separated from the broader ethical narrative of Scripture. For Christians, the ideas of compassion and love exist in a moral universe defined by the trajectory of creation, fall, redemption, and consummation. Humans bear the blessing of being created in the image of God while simultaneously inheriting the curse of both a human nature and an environment inclined towards sin. Sin distorts our self-understanding and misleads our ability to discern between the rightness or wrongness of our own desires. Our sinful human condition is why we desperately need to be saved by grace (Eph 2:1–10). As part of salvation, our own desires about gender need redeeming. Our resurrected and glorified bodies will be free from any kind of suffering or dissonance.[8]

Third, we can maintain Biblical moral boundaries while expressing Christian love and compassion. Sometimes, 1 John 4:8—“God is love”—is leveraged in compassion-based arguments for transitioning. But 1 John 1:5 also says “God is light,” a statement affirming God’s holiness. J.I. Packer commented on the connection between 1 John 1:5 and 1 John 4:8 and said, “So the God who is love is first and foremost light, and sentimental ideas of his love as an indulgent, benevolent softness, divorced from moral standards and concerns, must therefore be ruled out from the start. God’s love is holy love.”[9] For modern people, compassion and love are filtered through the autonomous individualism of the sexual revolution and mediated by a deficient view of Scripture. For Christians, compassion and love are joined to God’s holiness. Love always has moral boundaries, and the Biblical definition of love does not entail affirming everything a person may do. For example, John 3:16 famously says, “God so loved the world,” but obviously this does not mean God approves of everything humans do.

Christian compassion regarding gender transitioning is rooted in the creation narrative. Genesis 1:27 says, “Male and female he made them,” and helps us see that both the male and female bodies are good gifts to be received. The male body is not superior to the female body nor is the female body superior to the male body. Furthermore, when God completed the work of creation, he saw that it was “very good.” (Gen 1:31) Christian compassion to those suffering from gender dysphoria is bounded by God’s design and it is always compassionate to point back to God’s purposes.

Fourth, we can maintain the instruction that “Love does no wrong to a neighbor.” (Rom 13:10a). While our transgender neighbors may insist we are wronging them by not embracing gender reassignment as a way to resolve suffering associated with gender dissonance, Christians insist we are not wronging them by giving pushback on transitioning. First, we affirm each person is “fearfully and wonderfully made” (Ps 139:14) and that part of this wonder is each person’s natal sex (Gen 1:27). Second, complications associated with gender reassignment surgery give us reason to be concerned that affirming transitioning is in fact wronging a neighbor. In gender reassignment surgery, perfectly functioning urogenital tracts are being irreparably harmed and profound post-surgical complications are famously common in these procedures. Likewise, we are seriously concerned that these irreversible changes may not resolve the inner conflict that precipitated surgical and hormonal intervention. Consider the tragic case of Nathan Verhelst, a female to male transgender person from Belgium. Unhappy with the results of three separate sex change operations between 2009 and 2012, in 2013 Verhelst requested to be euthanized because of the suffering of depression and was put to death by Belgian doctors.[10]

Fifth, and as Verhelst’s case demonstrates, Christian compassion can exhibit very real concern for suicidal ideation common among gender dysphoric people. There is a not so subtle manipulation common in modern moral arguments in which Christians are accused of creating an environment that pushes gender dysphoric people to commit suicide. Parents of gender dysphoric children are sometimes asked, “Do you want a transgender child or do you want a dead child?” Christians do not want anyone experiencing gender dysphoria to commit suicide, but we reject the bifurcation between affirming gender transitioning or having someone die by suicide. A third option is found in the compassion described in the Bible. We can share with our gender dysphoric friends, “I grieve with you and I hurt for you. If I could take this burden away for you, I would, but I am not able to do that. But I am not leaving you. Together, we can find the way forward to embrace the goodness of the body God has given you. It will not be easy, but I am here and I’m not going away.” If we are not willing to be present with people expressing distress regarding gender, the trans-affirming community will most certainly be happy to do so.

Sixth, and finally, Christian compassion can point to God’s purposes in the suffering of gender dysphoria. We may never know all the reasons some people experience deep dissonance regarding gender, but we do know God uses painful trials for our good. James 1:2–4 says, “Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness.” If gender dysphoria is viewed in the light of this passage as a trial, then God can use it to produce in the future a more steadfast faith. Christians affirm life is meaningful and not meaningless. God can and does use suffering for his purposes, his glory, and our good.

UCLA’s Williams Institute said in 2022 that 1.6 million Americans over age 13 identify as transgender and that there are significant increases in the number of youth who identify as transgender.[11] At work, at school, at church, and in our families we will encounter people expressing various levels of questions about their own gender identity. Compassion divorced from Scripture becomes sloppy sentimentalism. Moral convictions divorced from compassion become brutal legalism. Conviction joined with compassion follows the model of Jesus who both preached against sin and yet came to seek and save the lost.


[1] Diane Sawyer and Bruce Jenner interview available at “Bruce Jenner: The Interview,” ABC News, April 24, 2015,

[2] Caitlyn Jenner (@Caitlyn_Jenner), Twitter, June 1, 2015,

[3] Editors, “Caitlyn Jenner Biography,”, October 5, 2016,

[4]  See Jason Rafferty et al., “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents,” Pediatrics 142, no. 4 (2018): Keep in mind that while the terms “transgender” and “gender dysphoria” are closely related, they are not identical. Gender dysphoria is a clinical diagnosis related to the distress caused by feelings of stress associated with gender dissonance.

[5] Modified from Peter D. Toon, “Compassion,” Encyclopedia of Biblical and Christian Ethics, rev. ed., ed. R. K. Harrison (Nashville, TN: Thomas Nelson, 1992), 80.

[6] Murray J. Harris, Colossians & Philemon, Exegetical Guide to the Greek New Testament (Grand Rapids, MI: Eerdmans, 1991), 160. See also BDAG, (2000), s.v. “οἰκτιρμοóς.”

[7] Peter D. Toon, “Compassion,” 80.

[8] Andrew T. Walker, God and the Transgender Debate (Charlotte, NC: Goodbook, 2017), 82–83.

[9] J.I. Packer, Knowing God (Downers Grove, IL: IVP Books, 1973, reprint 2018), 121–22.

[10] “Belgian Helped to Die after Three Sex Change Operations,” BBC, October 2, 2013,

[11] Jody L. Herman, Andrew R. Flores, and Kathryn K. O’Neill, “How Many Adults and Youth Identify as Transgender in the United States?” The UCLA School of Law, Williams Institute, June 2022,